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Contact Information

DESERT PAIN AND REHAB SPECIALISTS
11047 N 19TH AVE
PHOENIX, AZ85029
 Phone: 602-944-2222
 Fax: 602-331-2499
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
 

Addiction Medicine

207RA0401X 11 Physician/Internal Medicine
 

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for DESERT PAIN AND REHAB SPECIALISTS

NPI Number 1457416414
LBN Legal business name DESERT PAIN AND REHAB SPECIALISTS
Authorized official HERBERT GOODMAN - (CO-OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/27/2006
Last updated 06/24/2019 - About 7 years ago
Identifiers
AZ License # 11336
AZ License # 3984
AZ Medicaid 306932
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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